POTS symptoms

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POTS Place: A Guide to Postural Orthostatic Tachycardia Syndrome

Symptoms

Medical disclaimer Help Us

Postural Orthostatic Tachycardia is a syndrome. As such, there is a

collection of symptoms that distinguish it. The symptoms are widespread

because the autonomic nervous system plays an extensive role in regulating

functions throughout the body. Many of these symptoms, such as low blood

pressure, may present only after prolonged standing. Symptoms will vary from

person to person and will include some of the following:*

Tachycardia (Grubb, 2000)

Lightheadedness (Grubb, 2000)

Dizziness (Grubb, 2000)

Palpitations (Grubb, 2000)

Exercise intolerance (Grubb, 2000)

Blurred Vision (Grubb, 2000)

Chest discomfort and/or pain (Grubb, 2000)

Clamminess (Grubb, 2000)

Fainting or near fainting (Grubb, 2000)

Anxiety (Grubb, 2000)

Flushing (Grubb, 2000)

Fatigue (Grubb, 2000) (which can be disabling)

Headache/migraine (Grubb, 2000)

Shortness of breath (Grubb, 2000)

Postprandial hypotension (Grubb, 2000) (low blood pressure after meals)

Blood pooling in limbs (Grubb, 2000) (can make legs feel heavy and appear

mottled and purple in color)

Intolerance to heat (Grubb & Karas, 1999)

Feeling cold all over (Grubb & Karas, 1999)

Low blood pressure upon standing (Grubb, Kosinski, Boehm & Kip, 1997) (Some

physicians feel orthostatic hypotension is a separate entity from POTS)

Bloating after meals (Grubb et al., 1997)

Cognitive impairment (Grubb et al., 1997) (may include difficulties with

concentration, brain fog, memory and/or word recall)

Delayed gastric emptying (Grubb et al., 1997)

Polyuria ( & Biaggioni, 1999) (excessive urination)

Diarrhea ( & Biaggioni, 1999) (sometimes with alternating constipation)

Narrowing of upright pulse pressure ( & Biaggioni, 1999)

Tremulousness (Low, Opffer-Gehrking, Textor, Benarroch, Shen, Schondorf,

Suarez & Rummans, 1995)

Tunnel vision (Low et al.)

Sleep disorders (Low et al.) (can cause unrefreshing sleep and an increased

need for sleep)

Cold hands (Low et al.) (and often feet & nose)

Loss of sweating (Low et al.)

Hypovolemia (Low et al.) (low blood volume)

Chills (Low et al.)

High blood pressure (Low et al.)

Hyperventilation (Low et al.)

Numbness or tingling sensations (Low et al.)

Generalized weakness (Low et al.)

Reduced pulse pressure upon standing (Low et al.)

Low back pain (Mathias, 2000)

Aching neck and shoulders (Mathias, 2000)

Excessive sweating (on, 2000)

Nausea (on, 2000)

Noise sensitivity (, 2001)

Light Sensitivity (, 2001)

Disequalibrium (Sandroni, Opfer-Gehrking, McPhee & Low, 1999) The above are

symptoms reported by POTS researchers. Other symptoms sometimes reported by

POTS patients include:

Arrhythmias (irregular heart beats)

Chemical sensitivities (May have multiple chemical sensitivity and can be

very sensitive to medications - may only need small doses)

Easily over-stimulated

Feeling full quickly

Feeling " wired "

Food allergies/sensitivities (some foods seem to make symptoms worse)

Hyperreflexia

Irregular menstrual cycles

Loss of appetite

Loss of sex drive

Muscle aches and/or joint pains

Swollen nodules/lymph nodes

Polydipsia (excessive thirst)

Pupil abnormalities

Weight loss or gain

Feeling detached from surroundings

Restless leg syndrome POTS symptoms can vary from day to day. They tend to

multiply and become exaggerated upon upright posture. Blood flow and blood

pressure regulation are also abnormal while supine or sitting, but these

abnormalities may not be as apparent and may require orthostatic stress to

become evident ( & kson, 2002). Some patients do report symptoms

occurring while sitting or lying down. Women sometimes report an increase in

symptoms around menstruation.

If you are suffering from some of the above symptoms you need to seek

professional help. Please do not attempt self-diagnosis.

*Some of the above symptoms are specifically related to orthostatic

hypotension, traditionally defined as an excessive fall in BP (typically >

20/10 mm Hg) on assuming the upright posture. Not all patients will

experience a drop in blood pressure upon standing. Some physicians define

orthostatic hypotension as a separate entity from POTS.

References

1. Grubb, B. P. (2000, July). Orthostatic intolerance. National Dysautonomia

Research Foundation Patient Conference. Minneapolis, Minnesota.

2. Grubb, B. P., & Karas, B. (1999) Clinical disorders of the autonomic

nervous

system associated with orthostatic intolerance. Pacing and Clinical

Electrophysiology, 22, 798-810.

Full text: http://www.ndrf.org/disorders.PDF

3. Grubb, B. P., Kosinski, D.J., Boehm, K., & Kip, K. (1997). The postural

orthostatic tachycardia syndrome: a neurocardiogenic variant identified

during head-up tilttable testing. Pacing and Clinical Electrophysiology,

20, (9, Pt. 1), 2205-12. PMID: 9309745 [PubMed - indexed for MEDLINE]

4. , G., & Biaggioni I. (1999). Idiopathic orthostatic intolerance and

postural

tachycardia syndromes. The American Journal of the Medical Sciences,

317, 88-101. PMID: 10037112 [PubMed - indexed for MEDLINE]

5. Low, P. A., Oper-Gehrking, T. L., Textor, S. C., Benarroch, E. E., Shen,

W.

K., Schondorf, R., Suarez, G. A., & Rummans, T. A. (1995). Postural

tachycardia syndrome (POTS). Neurology, 45, (4, Supplement 5), S19-25.

PMID: 7746369 [PubMed - indexed for MEDLINE]

6. Mathias, C. J. (2000, July). Other autonomic disorders. National

Dysautonomia

Research Foundation Patient conference. Minneapolis, Minnesota.

7. on, D. (2000, July). General description of the autonomic nervous

system

and orthostatic intolerance overview. National Dysautonomia Research

Foundation Patient Conference. Minneapolis, Minnesota.

8. Sandroni, P., Opfer-Gehrking, T. L., McPhee, B. R., & Low, P. A. (1999).

Postural tachycardia syndrome: clinical features and follow-up study. Mayo

Clinic Proceedings, 74, (11), 1106-1110.

PMID: 10560597 [PubMed - indexed for MEDLINE]

9. , J. M., (2001, Spring/Summer). About being young and dizzy:

overview

of dysautonomia. National Dysautonomia Research Foundation Youth

Network Fainting Robins Newsletter, " The Young and the Dizzy " , 1, 1-2.

10. , J. M., & kson, L.C., (2002). Orthostatic intolerance: an

overview.

In Alejos, J. C., Konop, R., Chin, A. J., Herzberg, G., Neish, S. (Eds.).

emedicine Journal, 3, (1). http://www.emedicine.com/ped/topic2860.htm